Resistance Training for People With Heart Disease.

For years, physicians have advised middle-aged and older people to get "dynamic" exercise - that is, to engage in physical activity that emphasizes energetic movement of the arms and legs over longer periods of time. Dynamic (or "aerobic") exercise includes walking, jogging, and swimming. "Isometric" exercises require people to push hard against resistance (as with weight training, for example). Physicians traditionally have discouraged people with heart disease from pursuing resistance exercise for fear the abrupt surges in blood pressure common during these activities could be dangerous.

Recently, an expert panel organized by the American Heart Association endorsed a revised perspective on exercise. Now, cardiologists are actually recommending gentle resistance training for people with heart disease. The members of the panel believe that it is time to strip away some of the myths that surround weight training and other forms of resistance exercise.

Real Benefits

Each of the two types of exercise leads to very different effects on the body. Aerobic activities help lower blood pressure, tend to burn more calories, and are more likely to lead to weight loss. Resistance training builds muscle strength and endurance. However, when the experts reviewed scientific data on the health benefits of aerobic exercise and resistance training, they found more similarities than differences. (See table.)

Aerobics and resistance workouts do a good job helping to maintain bone mineral density, and therefore reduce the chances of hip or spine fractures. Perhaps even more striking though, is the fact that the two types of exercise have pretty much the same effect on coronary artery disease risk factors. Both lead to modest reductions in tendencies toward diabetes, high cholesterol, and hypertension. While aerobic exercise is better at lowering systolic blood pressure (the top number), both forms of exercise reduce diastolic blood pressure (the bottom number). (Circulation, Vol. 101, No. 67, pp. 828-833.)

Benefits and Risks for Heart Patients

American Heart Association experts were impressed by the realization that resistance training can favorably affect the chronic conditions many older people and cardiac patients develop. These conditions include osteoporosis, susceptibility to falls, and diabetes. In addition, the panel noted that many cardiac patients lack the physical strength and self-confidence to perform routine activities of daily life. Gentle weight training can help address those problems.